VBS 2025 Registration

Child's Name

Parent/Guardian's Name

Street Address

Mailing Address (if different)

Phone (home)  

Phone (work)  

Phone (cell)   

EMERGENCY CONTACT NAME 

EMERGENCY PHONE 

Email Address 

Child's Birthdate  

Grade just completed: 

Medical or other info that we need to know (e.g., allergies?):

Dismissal Information: 

Who may pick up your child at the end of each evening's session (IF other than parent)?                       

Other Information:  

Does your child attend Sunday School?  If so, where?

If your child is visiting us, who is he a guest of?

May we have permission to photograph your child? (yes/no)

May we have permission to use your child's photograph for the purpose of promotion? (yes/no)

Thank YOU!